Polski Merkuriusz Lekarski最新文献

Objective: Aim: To investigate the impact of the improved Working Program of the academic subject "Special Physical Training" on the dynamics of indicators of cadets' physical and psycho-emotional state in their training process..

Patients and methods: Materials and Methods: The research, which was conducted in 2023-2024, involved 167 male cadets of the 3rd and 4th training years of National Academy of Internal Affairs (Kyiv, Ukraine). Two groups were formed: the experimental group (EG, n = 86), whose cadets studied according to the improved Working Program of the academic subject area referred to as "Special Physical Training," and the control group (CG, n = 81), whose cadets studied according to the existing Working Program. Research methods: bibliosemantic, pedagogical experiment, testing, methods of mathematical statistics.

Results: Results: The research found that at the end of the experiment, most of the studied indicators of physical and psycho-emotional state in the EG cadets were significantly better than in the CG cadets. The most pronounced effect of the training sessions with the improved Working Program was found in the indicators of anxiety, neuro-emotional stability, self-confidence, stress resistance, and endurance of future law enforcement officers.

Conclusion: Conclusions: A high level of these indicators will ensure the formation of law enforcement officers' psychophysical readiness for extreme conditions. It will help to improve the efficiency of their performance of service tasks under martial law.

Objective: Aim: The aim is to analyze the possibilities of coaching technologies for training future specialists in the field of education for sustainable development in war conditions, to characterise the role of psychoeducation in this process..

Patients and methods: Materials and Methods: The research used a number of scientific methods: general scientific (analysis, synthesis, generalization), specific search, and analysis of the source base, made it possible to determine the general trends in the study of the problem of the psychoeducation in the process of professional training of future specialists for sustainable development in wartime conditions, analyze the achievements of Ukrainian and foreign scientists, to distinguish the common and the different in the scientific research of scientists.

Conclusion: Conclusions: One of the tools for ensuring the development of education under wartime conditions, as our experience shows, is the introduction of the latest technologies, in particular coaching, and the actualization of psychoeducation, which under the conditions of the russian-Ukrainian war gained special importance in the professional training of specialists in view of the constant need for psychological support with the help of all participants in the educational process. Various methods, tools and forms of psychoeducation serve as psychological assistance to higher education students, and through the introduction of coaching technologies, it is possible to achieve not only the formation of key competencies of future professionals, increase their general culture, improve mental health, but also to constantly improve themselves, form the ability to comprehend, overcome various mental problems, stressful situations, and finally, to maintain physical, mental, and spiritual health in war time.

This case report describes the clinical course in a great age home hospice patient with advanced lip cancer, who was cured as a result of palliative care and radiotherapy specialists' cooperation. A 91-year-old Caucasian male developed a lip tumor over five years. Given his passive approach to health and challenging living conditions, he opted not to undergo the recommended surgical treatment. As the lip lesion progressed, and pain and trismus increased, making him unable to eat, he was placed under home hospice care. Seeking the best treatment strategy, the hospice physician referred him to a radiotherapist, who qualified him for sequential radiotherapy. Initially, external beam radiotherapy was administered, delivering a total dose of 30 Gy in 10 fractions using the IMRT technique, which resulted in over 60% tumor regression. Subsequently, an HDR 3D interstitial brachytherapy boost was applied, delivering an additional dose of 24 Gy in 6 fractions. This treatment led to a remarkable resolution of the lesion. Throughout this process, comprehensive supportive care was continuously provided as the patient temporarily developed CTCAE grade 3 oral toxicity, which required intensive local and analgesic therapy for five weeks. Ultimately, the patient's fitness greatly improved. This case report highlights the importance of comprehensive supportive treatment and multidisciplinary cooperation, as well as the effectiveness of radiotherapy in palliative care.

Objective: Aim: The aim of the present study is to analyse and summarize the experience of the Department of Reconstructive and Plastic Microsurgery of the National Scientific Center of Surgery named after A.N. Syzganov in the field of treatment of hand injuries..

Patients and methods: Materials and Methods: The study sample included 295 patients who applied to the Department of Reconstructive and Plastic Microsurgery of the National Scientific Center of Surgery named after A.N. Syzganov from the beginning of 2021 to the end of 2022, in relation to which general clinical methods of research, including the method of dynamic observation and innovative microsurgical techniques, were applied. Innovative minimally invasive surgical techniques were developed and successfully applied to the flexor tendons of the fingers, ensuring precise juxtaposition of tendon ends, reducing tissue trauma, and facilitating smooth passage of the repaired tendons in bone-fibrous canals.

Results: Results: The application of the developed methods demonstrated high clinical efficacy, as evidenced by the high percentage of good and satisfactory treatment results - 98.8% in one group and 93.7% in the other. Nevertheless, in 3.4% of cases, the development of flexion contractures of fingers of different severity was observed, which was associated with insufficient intensity of rehabilitation, lack of proper dynamic control and indiscipline of some patients.

Conclusion: Conclusions: The result of the work was a comprehensive analysis of the experience of microsurgery of the hand obtained in the Republic of Kazakhstan during the study period.

Objective: Aim: The aim of this study was to investigate and correlate psychosocial risks and musculoskeletal disorders (MSDs) faced by nurses in the hospital work environment..

Patients and methods: Materials and Methods: A cross-sectional study was conducted among 90 nurses (response rate: 56%) working in a General Hospital of Central Greece, from January to March 2023. A self-administered questionnaire was used for data collection, which included demographic information, characteristics of the nursing unit, the Copenhagen Psychosocial Questionnaire Version III (COPSOQ III), and the Nordic Musculoskeletal Questionnaire.

Results: Results: No statistically significant differences were found between individual factors and the COPSOQ scales under examination, except for gender. Professional characteristics, however, were associated with psychosocial risks. For example, an increase in the number of nurses was positively associated with work demands. Conversely, night shifts were negatively associated with freedom of movement, as was the length of employment with opportunities for career development and the assessment of leadership quality. No statistically significant differences were found between MSDs and individual factors. Regarding the correlation between psychosocial risks and MSDs, the study revealed several associations among COPSOQ scales, such as work demands, work-life balance, freedom of movement, social support from colleagues and supervisors, job insecurity and satisfaction, interactions with others, health assessment, and mental exhaustion, with the occurrence of MSDs in body areas such as the neck, shoulders, elbows, wrists, hips, upper back, and ankles.

Conclusion: Conclusions: The hospital work environment entails numerous psychosocial risk factors, and ensuring its safety requires their identification and evaluation. Interventions such as ergonomics training, acquiring ergonomic equipment, avoiding manual lifting, and training on the use of patient handling devices can increase risk awareness, reducing the frequency and intensity of musculoskeletal pain.

Objective: Aim: To gain knowledge about the attitudes of medical students towards people with intellectual disabilities and the impact of psychiatry teaching on changing these attitudes..

Patients and methods: Materials and Methods: The study involved 106 students of medical faculties who had not yet taken a course in psychiatry and 104 who had completed the course and passed the exam. The interviewers who conducted the research were the students themselves. The tool used in the study was a questionnaire of own design designed by a special educator and a psychiatrist. The questionnaire included questions about age and gender, as well as 5 statements of a discriminatory (rejecting) nature and 5 affirmative (accepting) statements indicating full acceptance of people with intellectual disabilities.

Results: Results: Most of the people surveyed presented positive attitudes towards people with intellectual disabilities (approx. 88%). Approximately 12% of the respondents presented negative attitudes reflecting social stereotypes. The groups of students before and after completion of the classes in this subject did not differ in the frequency of the 10 selected attitudes studied.

Conclusion: Conclusions: The vast majority of medical students surveyed present positive attitudes (judgments) regarding people with intellectual disability. Approximately 12% of the surveyed medical students present negative attitudes (judgments) towards persons with intellectual disability. There is no correlation between the completion of psychiatry classes and the frequency of negative attitudes (judgments) towards persons with intellectual disability among the surveyed medical students.

Objective: Aim: To conduct a forensic medical and legal analysis of cases of improper performance of professional duties by medical employees, including incorrect prescription of medical products..

Patients and methods: Materials and Methods: The article is based on the analysis of defects in the performance of professional duties by medical employees, particularly according to data from commission forensic medical examinations, as well as an analysis of international and national legal acts and national judicial practices of Ukraine. Dialectical, hermeneutic, comparative, analytical, synthetic, and system analysis research methods were used.

Results: Results: Although the total number of forensic medical examinations tends to decrease, these examinations remain the focus of attention in cases of improper performance of professional duties by medical employees. A more detailed analysis of cases involving violations of treatment strategies revealed instances of incorrect treatment method selection (whether conservative or surgical), along with cases of improper or unjustified prescription of medicinal products. Incorrect prescription of medical products is one significant way medical employees fail in their professional duties.

Conclusion: Conclusions: Understanding the general dynamics of forensic medical examinations is important, as it helps establish practical cause-and-effect relationships between the performance of professional duties by medical employees and adverse consequences for patients (including cases involving incorrect prescription of medical products).

The amniotic membrane, which lacks blood vessels, lymphatic vessels and nerves, is a thin membrane with anti-inflammatory and anti-scarring properties. In the field of dentistry, it is primarily employed as a dressing following the removal of malignant or pre-malignant lesions, with the objective of ensuring haemostasis and the absence of allergic reactions. Furthermore, it is employed in the treatment of oro-auricular junctions, cleft palates and in guided bone regeneration, due to the presence of mesenchymal cells. In vestibuloplasty, it has been demonstrated to enhance vestibular deepening, accelerate epithelialisation and reduce pain. In periodontics, it has been shown to be an effective treatment for gingival recession and furcation defects, and to increase the width of keratinised gingiva around implants. In endodontics, it is employed in regenerative procedures, offering comparable results to standard methods. Furthermore, in the treatment of osteoarthritis of the temporomandibular joint, it has been observed to provide pain relief and improved joint function.

Objective: . Aim: The aim of this ambispective, two-center, observational study was to evaluate the clinical characteristics and 3-years prognosis of patients with non-STelevation myocardial infarction (NSTEMI) and AF.

Patients and methods: Materials and methods: Patients hospitalized with a diagnosis of NSTEMI were included. Baseline demographic and clinical features, in-hospital procedures, and occurrence of cardiovascular events in patients with sinus rhythm (SR) and AF confirmed before admission were analyzed.

Results: Results: A total of 273 patients with NSTEMI were enrolled between 2012 and 2015, of whom 102 had AF (37.3%, 60.8% men) and 171 had SR (64.3% men). Patients with AF and NSTEMI were significantly older: 76.6±8.4 vs. 65.9±11.1 years (p<0.0001). The permanent pattern of AF was observed in 54 patients (52.9%) and paroxysmal in 48 patients (47.1%). They more often had heart failure with higher NYHA class (p<0.0001), type 2 diabetes (p=0.0001), abnormal renal function (p<0.0001), and history of stroke (p<0.0001). The presence of AF was not correlated with the number of stenotic coronary vessels. Significantly more NSTEMI patients with AF had a pacemaker implanted before admission (p<0.0001). Duration of hospital stay of NSTEMI AF patients was longer: 10.5±9.9 vs.6.6±4.2 days and it was related to age, Rho=0.5,p=0.0002. During the 2-year and 3-year follow-ups, AF was significantly related to higher mortality, both cardiovascular disease and all-cause mortality (p<0.0001). Independent long-term all-cause mortality predictors were heart failure, liver insufficiency, and age. At the 3-years follow-up, there were no significant differences in all-cause and cardiovascular mortality between groups with permanent AF and paroxysmal AF (p=0.696).

Conclusion: Conclusions: Patients with atrial fibrillation and NSTEMI were older and more likely to have comorbidities. During the 2-year and 3-year follow-ups, AF was related significantly to higher mortality, both cardiovascular and of all causes. The long-term prognosis of patients with AF was adversely affected by heart failure, liver insufficiency and age.

Objective: Aim: This study explores the feasibility and psychosocial outcomes of using somatic methods as a mental and psychosocial health intervention in the context of active violent conflict..

Patients and methods: Materials and Methods: Project leaders taught an 8-day program in somatic methods to local mental health care providers in the Donbas region of Ukraine. In the following seven months, 20 mental health care providers applied the somatic methods in their work with clients. The progress of clients participating in the study was tracked utilizing a software designed for the project. Longitudinal data was collected from 460 clients between December 2020 and May 2021 and was analyzed using mixed linear models to estimate changes in outcomes of depression, functionality, anxiety and alcohol problems.

Results: Results: The program was successfully implemented despite the challenges posed by the ongoing conflict. Demographic data on participants and survey results were successfully collected and analyzed. Data demonstrated significant declines over time for depression and anxiety as well as a significant increase in daily functioning.

Conclusion: Conclusions: The results of this pilot study support the feasibility of developing a subsequent randomized controlled trial study to further assess the impact of somatic methods on psycho-social wellness in Ukraine.